Tuberculosis Treatment Loss to Follow-up in Children Exposed at Home: A Prospective Cohort Study

Meredith B. Brooks; Brittney J. van de Water; Leonid Lecca; Chuan-Chin Huang; Letizia Trevisi; Carmen Contreras; Jerome T. Galea; Roger Calderon; Rosa Yataco; Megan Murray; Mercedes C. Becerra

doi:10.7189/jogh.14.04194

Tuberculosis Treatment Loss to Follow-up in Children Exposed at Home: A Prospective Cohort Study

Meredith B. Brooks, Brittney J. van de Water, Leonid Lecca, Chuan-Chin Huang, Letizia Trevisi, Carmen Contreras, Jerome T. Galea, Roger Calderon, Rosa Yataco, Megan Murray, Mercedes C. Becerra

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Loss to follow-up (LTFU) from tuberculosis (TB) treatment and care is a significant public health problem. It is important to understand what drives LTFU in children – a population whose treatment and management depend on an adult caregiver – to better provide support services to families affected by TB.

Methods: We conducted a prospective cohort study of household contacts in Lima, Peru (2009–12). Using multilevel logistic regression analysis, we explored individual-level characteristics of children and their adult household members with TB disease to identify risk factors for LTFU among children initiated on treatment for TB.

Results: A total of 154 child (0–14 years) household contacts were diagnosed with TB and initiated on treatment. While most (n = 133, 86.4%) had a successful outcome, 20 (13.0%) children were LTFU. Six (30.0%) children were LTFU within three months, nine (45.0%) between five to seven months, and three (15.0%) after seven months of treatment being initiated. In univariable analysis, children with index patients above 25 years of age had decreased odds of being LTFU (odds ratio = 0.26; 95% confidence interval = 0.08-0.84) compared to children with index patients 25 years or younger.

Conclusions: In this cohort, more than 10% of children sick with TB who were exposed to the disease at home were LTFU. An integrated, family-centred TB prevention and management approach may reduce barriers to a child completing their course of TB treatment.

Original language	American English
Article number	04194
Journal	Journal of Global Health
Volume	14
DOIs	https://doi.org/10.7189/jogh.14.04194
State	Published - Jan 1 2024

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Cite this

@article{10f0274f6213417ab88075e429d84589,

title = "Tuberculosis Treatment Loss to Follow-up in Children Exposed at Home: A Prospective Cohort Study",

abstract = "Background: Loss to follow-up (LTFU) from tuberculosis (TB) treatment and care is a significant public health problem. It is important to understand what drives LTFU in children – a population whose treatment and management depend on an adult caregiver – to better provide support services to families affected by TB. Methods: We conducted a prospective cohort study of household contacts in Lima, Peru (2009–12). Using multilevel logistic regression analysis, we explored individual-level characteristics of children and their adult household members with TB disease to identify risk factors for LTFU among children initiated on treatment for TB. Results: A total of 154 child (0–14 years) household contacts were diagnosed with TB and initiated on treatment. While most (n = 133, 86.4\%) had a successful outcome, 20 (13.0\%) children were LTFU. Six (30.0\%) children were LTFU within three months, nine (45.0\%) between five to seven months, and three (15.0\%) after seven months of treatment being initiated. In univariable analysis, children with index patients above 25 years of age had decreased odds of being LTFU (odds ratio = 0.26; 95\% confidence interval = 0.08-0.84) compared to children with index patients 25 years or younger. Conclusions: In this cohort, more than 10\% of children sick with TB who were exposed to the disease at home were LTFU. An integrated, family-centred TB prevention and management approach may reduce barriers to a child completing their course of TB treatment.",

author = "Brooks, \{Meredith B.\} and \{van de Water\}, \{Brittney J.\} and Leonid Lecca and Chuan-Chin Huang and Letizia Trevisi and Carmen Contreras and Galea, \{Jerome T.\} and Roger Calderon and Rosa Yataco and Megan Murray and Becerra, \{Mercedes C.\}",

year = "2024",

month = jan,

day = "1",

doi = "10.7189/jogh.14.04194",

language = "American English",

volume = "14",

journal = "Journal of Global Health",

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TY - JOUR

T1 - Tuberculosis Treatment Loss to Follow-up in Children Exposed at Home: A Prospective Cohort Study

AU - Brooks, Meredith B.

AU - van de Water, Brittney J.

AU - Lecca, Leonid

AU - Huang, Chuan-Chin

AU - Trevisi, Letizia

AU - Contreras, Carmen

AU - Galea, Jerome T.

AU - Calderon, Roger

AU - Yataco, Rosa

AU - Murray, Megan

AU - Becerra, Mercedes C.

PY - 2024/1/1

Y1 - 2024/1/1

N2 - Background: Loss to follow-up (LTFU) from tuberculosis (TB) treatment and care is a significant public health problem. It is important to understand what drives LTFU in children – a population whose treatment and management depend on an adult caregiver – to better provide support services to families affected by TB. Methods: We conducted a prospective cohort study of household contacts in Lima, Peru (2009–12). Using multilevel logistic regression analysis, we explored individual-level characteristics of children and their adult household members with TB disease to identify risk factors for LTFU among children initiated on treatment for TB. Results: A total of 154 child (0–14 years) household contacts were diagnosed with TB and initiated on treatment. While most (n = 133, 86.4%) had a successful outcome, 20 (13.0%) children were LTFU. Six (30.0%) children were LTFU within three months, nine (45.0%) between five to seven months, and three (15.0%) after seven months of treatment being initiated. In univariable analysis, children with index patients above 25 years of age had decreased odds of being LTFU (odds ratio = 0.26; 95% confidence interval = 0.08-0.84) compared to children with index patients 25 years or younger. Conclusions: In this cohort, more than 10% of children sick with TB who were exposed to the disease at home were LTFU. An integrated, family-centred TB prevention and management approach may reduce barriers to a child completing their course of TB treatment.

AB - Background: Loss to follow-up (LTFU) from tuberculosis (TB) treatment and care is a significant public health problem. It is important to understand what drives LTFU in children – a population whose treatment and management depend on an adult caregiver – to better provide support services to families affected by TB. Methods: We conducted a prospective cohort study of household contacts in Lima, Peru (2009–12). Using multilevel logistic regression analysis, we explored individual-level characteristics of children and their adult household members with TB disease to identify risk factors for LTFU among children initiated on treatment for TB. Results: A total of 154 child (0–14 years) household contacts were diagnosed with TB and initiated on treatment. While most (n = 133, 86.4%) had a successful outcome, 20 (13.0%) children were LTFU. Six (30.0%) children were LTFU within three months, nine (45.0%) between five to seven months, and three (15.0%) after seven months of treatment being initiated. In univariable analysis, children with index patients above 25 years of age had decreased odds of being LTFU (odds ratio = 0.26; 95% confidence interval = 0.08-0.84) compared to children with index patients 25 years or younger. Conclusions: In this cohort, more than 10% of children sick with TB who were exposed to the disease at home were LTFU. An integrated, family-centred TB prevention and management approach may reduce barriers to a child completing their course of TB treatment.

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